Ukulimala kwe-humerus ukuxhaphaza okuqhelekileyo kwiphepha. Eyona nto ixhaphakileyo kubantu asebekhulile ngenxa ye- osteoporosis , i-humerus ephazamisayo i-break-errac are among the bones of the bones . Enyanisweni, kwizigulane ezingaphezu kwama-65, i-humerus i-fracture ehamba phambili iyona yesithathu exhaphakileyo isifuba (emva kokuphuka kwe-hip kunye nokwahluka kwesandla ).
Ukuphuka kwe-humerus okuxhamlayo kwenzeka xa ibhola, ibhola kunye ne-socket joint joint, liphukile. I-fracture ikuncinci phezulu kwethambo lesangqa (i-humerus). Ininzi ye-humerus ye-fracture ayikho indawo yokuhlala (kungekho ngaphandle kwesikhundla), kodwa malunga ne-15-20% yalezi ziqhekeza ziyafuduswa, kwaye ezi zifuna unyango olongezelelweyo.
Ingxaki eyona nto ibaluleke kakhulu ngokunyuka kwama-humerus amaqhekeza kukuba unyango lukhawuleza, kwaye iziphumo zihlala zilungile okanye zihlwempu. Izigulane ezininzi ezigcina le nzakalo ayinakufumana amandla okanye ukuhamba kwegxala, nangona unyango olufanelekileyo.
I-Humper Proximal Proracimal Fractures
Xa ithambo lingekho ukulungelelaniswa okufanelekileyo, i-fracture ibizwa ngokuba yi-displaced. Kwi-humerus ephazamisayo, ixinzelelo lidla ngokuchazwa ngoluphi uhlobo lwezona zinto eziphambili ze-humerus eziqhekezayo. Kukho "iingxenye" ezine ze-humerus ezixhomekeke kuyo, ngoko ukuphuka kwendawo ekhutshwe kuyo kungaba yinxenye-2, inxenye-3, okanye inxalenye-4 (i-fracture engekho-displaced is, by definition, 1-part).
Ngokuqhelekileyo, iindawo ezininzi ezifudukisiwe, zibi kakhulu.
Iindawo ze-humerus ezixhamlayo zibizwa ngokuba yi-tuberosity (i-tuberosity enkulu nangaphezulu), intloko ehluthayo (ibhola lehlombe), kunye ne-shaft shamer. Iibhulogi zilandelayo kwibhola kwaye ziqhotyoshelweyo zezihlunu ezibalulekileyo ze- rotator .
Ukuze inxalenye ithathelwe ingqalelo kwiindawo ezifudumeleyo, mhlawumbi kufuneka ihlukaniswe kwindawo yayo eqhelekileyo ngaphezu kweyentimitha okanye ijikelezwe ngaphezulu kwama-45 degrees.
Unyango
Phantse i-80% yezidumbu ze-humerus eziphambeneyo ezingekho kwiindwendwe (kungekho ngaphandle kwesikhundla), kwaye ezi zinto ziphantse ziphathwe ngentshontsho. Unyango oluthile luya kuphumla ihlombe kwi-sling kwiiveki ezi-2-3, kwaye ke uqale ezinye izilwanyana ezihambayo . Njengoko uphilisa inkqubela phambili, uqeqesho olunamandla olusisigxina luyaqalisa kwakhona, kwaye ukuphilisa okupheleleyo kuthatha malunga neenyanga ezi-3.
Xa kunobungozi obukhulu apho ithambo lifuduka khona (ngaphandle kwesimo), kunokufuneka ukuba ulungelelanise okanye utshintshe ithambo elonakalisiweyo. Ukuqwala unyango olungcono kuncike kwiimeko ezininzi ezibandakanya:
- Ubudala besigulane
- Ukubamba isandla
- Umgangatho womsebenzi wesigulane
- Umgangatho wokufuduka kweqhekeza
Izinketho zokuhlinzwa ziquka ukulungiswa kweengcezu zethambo nokuzibeka kwiindawo zokufakelwa kwezinyithi, okanye inkqubo yokutshintshwa kwefayili yenziwa. Ukuba iinqununu zethambo zingagqitywa, ngaba izikhonkwane, izikrini, iingcingo, i- sutures ezinkulu, okanye ipake izakusetyenziswa ukubeka amathambo endaweni. Iiplati kunye nezikrini, njengoko zifanekiselwe apha ngasentla, ziye zaba zixhaphake kakhulu njengoko ubugcisa bezobuchwepheshe buphucule.
Ukuba kukho iinkxalabo malunga nokulungiswa kwethambo, kunokugqitywa ukuba kwenziwe uhlobo oluthile lwefayili. Ukuba inkqubo yokutshintshwa iphakanyisiwe, ukhetho luquka ukutshintshwa kwegxina eliqhelekileyo, i- hemiarthroplasty , okanye ukutshintshelwa kwegxala . Isiphakamiso esithile soluphi uhlobo lotyando olulungileyo luxhomekeka kwizinto ezininzi ezibandakanya uhlobo lwekhefu kunye nesigulane esithile. Ngokomzekelo, ukuguqula indawo yokubuyisela iigxina kungabakho unyango ogqithisileyo kodwa kugcinelwe izigulane ezisebekhulile, ezincinci.
Iingxaki
Ngelishwa, i-humerus ephazamisekayo imfucuza ixakeka kakhulu, ingakumbi xa ukulungiswa kwethambo kuye kwashintsha kakhulu.
Ukuyeka kwimiba yexanduva akuqhelekanga, kwaye abantu abahlala bekhuselekile bahlala bengagcini amandla abo okanye ukuhamba ngokubambisana. Ngenxa yokuxhatshazwa kumxhelo, ukuphuhliswa kwe-arthritis yokuqala kwinto eqhelekileyo yolu xhatshazo.
Ezinye zeengxaki ezinxulumene ngqo nokunyangwa ngonyango lwe-humerus fractures ezixakekayo zibandakanya ukusuleleka, iingxaki zokuphilisa, ukulimala kwentsholongwane, nokungabikho kokuphulukiswa kwethambo. Eyokugqibela kwezi, ezibizwa ngokuba yi- nonunion , zenzeka xa ithambo lihluleka ukudibanisa, kwaye i-fracture ivela kwakhona. I-hardware yensimbi esetyenziselwa ukulungisa i-bone ephukile ayifanelekanga ukuba isisombululo sisesigxina, kunokuba ithatha ithambo endaweni ngenkathi kuphulukiswa. Ukuba ithambo aliphilisanga ngokupheleleyo, ngoko ke izifake zetsimbi ziya kugcina zingaphumeleli, kwaye ngokuqhelekileyo, ukuphinda unyango kufuneka ziqwalaselwe.
Imithombo:
Nho SJ, et al. "Ukulungiswa koLawulo lwe-Humerus Fractures" e-Displaced Proximal Proracimal Fractures "J Am Acad Orthop Surg January 2007. 15 no. 1 12-26